Dr. A.P.J. ABDUL KALAM UNIVERSITY, INDORE (M.P.
)
Indore Dewas Bypass Road, Arandia, Indore - 452016
Application Form For Issue of Migration/Provisional/Transcript Certificate
To be filled by the office
Recent Passport
To, Certificate No…………………………………
size Photograph
The Registrar, Dispatch No…………………………………… duly attested by
Dr. A.P.J. Abdul Kalam University, Date………………………………………………. Director/Principal
with seal
Indore. Dealing Asstt.
Sir,
I was a student of this University studied as Regular/Ex -student in the ………...................................................
.....................………………………………………………….……………………………………………………………………………………...…………. (College)
and passed the examination in the Month and Year……………………………………… in ........................................ Division. I
request you to kindly issue me Migration/Provisional Certificate.
The necessary fee of Rs. ………………………………….……………………….………….………………………. has been deposited in
Bank Draft No. ……………………………………. of Bank ……..……………………………………………... Dated…………………………………….……….
1. Full Name in English (In Capital Letters) ……………………………….……………………….………………….……………………………………
2. Full Name in Hindi ……………………..……………….………………………………………………...……………….………………………………….….
3. Father's Name …………………………………………………………………………………………….………………………………………………………...
4. Mother’s Name ………………………………………………………………………………………….………………………………………………………….
5. Examination last appeared/passed …..……………………… Year …..……………………… Division/Grade …..………………………
6. Marks obtained in last semester/year ……………………….…..….. Out of ….…………..……..…
7. Grand total (Including all semester/year) …………….…………….. Out of ………………….…..…
8. Branch …………………………………………………… Enrollment No.: ……………………………………………………..……………………………
9. Name of the Institution………………………………………………………………………………………………………………………………………….
Date:……………………………
Address:……………………………………………………. Yours faithfully
………………………………………………………………….
Pin………………………Phone………………………….. (Signature of Student)
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CERTIFICATE TO BE RECORDED BY THE PRINCIPAL/HEAD OF THE INSTITUTION
Certified that the eligibility for award of Migration/ Provisional certificate have been checked with
the original of the concerned certificates, marksheets, office record of the institution and found correct.
The candidate may be issued the desired certificate.
Signature and seal of the Principal/Head of the Institution
Enclosures required: (Please tick () in appropriate box if enclosed)
1. For Provisional Certificate please enclose a copy of the Final Semester/Year Marksheet attested by the concerned
Principal/Head of the Institution.
2. For Migration Certificate please enclose copies of the Final Semester/Year Marksheet and T.C. attested by the
concerned Principal/Head of the Institution.
3. For Transcript Certificate please enclose a copy of the 1st to Final Semester/Year Marksheet attested by the concerned
Principal/Head of the Institution.
4. Demand Draft is payable in favor of Dr. A.P.J. Abdul Kalam University (Exam), Indore.
Note:
1. Migration, Provisional and Transcript certificate will be issued after 30 days of receipt of application with prescribed fees.
2. Incomplete application(s) without requisite enclosure (as above) shall not be considered.
3. Recent passport size photograph self attested.
Non Refundable Fees:
Migration Certificate Rs. 150/- Provisional Certificate Rs. 200/-
Postal Charge Rs. 50/- extra Postal Charge Rs. 50/- extra
Transcript Certificate Rs. 1000/- Second Copy Onwards Rs. 500/-
Postal Charge Rs. 50/- extra Postal Charge Rs. 50/- extra
Note: Please use separate form for each Certificate.